Childhood abuse affects adult health. The objective of this study was to examine the association between a self-reported history of childhood abuse and fear of childbirth.
A population-based, cross-sectional study was conducted of 2,365 pregnant women at five obstetrical departments in Norway. We measured childhood abuse using the Norvold Abuse Questionnaire and fear of childbirth using the Wijma Delivery Expectancy Questionnaire. Severe fear of childbirth was defined as a Wijma Delivery Expectancy Questionnaire score of = 85.
Of all women, 566 (23.9%) had experienced any childhood abuse, 257 (10.9%) had experienced emotional abuse, 260 (11%) physical abuse, and 290 (12.3%) sexual abuse. Women with a history of childhood abuse reported severe fear of childbirth significantly more often than those without a history of childhood abuse, 18 percent versus 10 percent (p = 0.001). The association between a history of childhood abuse and severe fear of childbirth remained significant after adjustment for confounding factors for primiparas (adjusted OR: 2.00; 95% CI: 1.30-3.08) but lost its significance for multiparas (adjusted OR: 1.17; 95% CI: 0.76-1.80). The factor with the strongest association with severe fear of childbirth among multiparas was a negative birth experience (adjusted OR: 5.50; 95% CI: 3.77-8.01).
A history of childhood abuse significantly increased the risk of experiencing severe fear of childbirth among primiparas. Fear of childbirth among multiparas was most strongly associated with a negative birth experience.
Prevention of lumbopelvic pain in pregnancy has been sparsely studied. One aim of this study was to assess if a 12-week training program during pregnancy can prevent and/or treat lumbopelvic pain. A randomized controlled trial was conducted at Trondheim University Hospital and three outpatient physiotherapy clinics. Three hundred and one healthy nulliparous women were included at 20 weeks of pregnancy and randomly allocated to a training group (148) or a control group (153).
The outcome measures were self-reported symptoms of lumbopelvic pain (once per week or more), sick leave, and functional status. Pain drawing was used to document the painful area of the body. The intervention included daily pelvic floor muscle training at home, and weekly group training over 12 weeks including aerobic exercises, pelvic floor muscle and additional exercises, and information related to pregnancy.
At 36 weeks of gestation women in the training group were significantly less likely to report lumbopelvic pain: 65/148 (44%) versus 86/153 (56%) (p=0.03). Three months after delivery the difference was 39/148 (26%) in the training group versus 56/153 (37%) in the control group (p=0.06). There was no difference in sick leave during pregnancy, but women in the training group had significantly (p=0.01) higher scores on functional status.
A 12-week specially designed training program during pregnancy was effective in preventing lumbopelvic pain in pregnancy.
Comment In: Aust J Physiother. 2007;53(3):20217899664
Department of Nursing and Health Promotion, Oslo and Akershus University College of Applied Sciences, P.O. Box 4 St. Olavs plass, 0130 Oslo, Norway; Division of General Gynaecology and Obstetrics, Oslo University Hospital, P.O Box 4950 Nydalen, N-0424 Oslo, Norway. Electronic address: firstname.lastname@example.org.
this study aimed to explore factors associated with a negative childbirth experience including descriptions from women themselves.
we performed a mixed methods study based on data from the Norwegian cohort of the Bidens study, including a total of 1352 multiparous women. Quantitative information was analysed in addition to thematic analysis of 103 free-text comments provided by women with a prior negative childbirth experience.
the total prevalence of a negative birth experience was 21.1%. A negative experience was associated with fear of birth (AOR: 5.00 95% CI 3.40-7.23) and a history of abuse (AOR 1.34 95% CI 1.01-1.79) in multivariate analysis. Women who indicated they were para 2 were less likely or report a negative childbirth (AOR 0.66 95% CI 0.46-0.94). Three major themes were identified: 'complications for mother, child or both', 'not being seen or heard'; and 'experience of pain and loss of control'. The majority of respondents reported experiences of unexpected and dramatic complications during childbirth. Further, several of the respondents felt a lack of support, that they had not been treated with respect or included in decisions regarding their birth. A minority described pain and loss of control as the main reason for their negative birth experience.
comments by the women show that they were unprepared for complications and inadequate care during birth. The feeling of not being seen or heard during childbirth contributed to a negative experience. Midwives can use the information gained from this study to prevent negative birth experiences.
To examine the association between childhood abuse and fear of childbirth and the wish for cesarean section during second pregnancy.
A longitudinal cohort study using data from the Norwegian Mother and Child Cohort Study (MoBa) conducted by the Norwegian Institute of Public Health.
Fifty maternity units in Norway, 1999-2006.
We included 4,876 women who participated in the MoBa study during their first and second pregnancy.
Postal questionnaires at 18 and 30 weeks' gestation and 6 months postpartum linked to the Medical Birth Registry of Norway.
Associations between childhood abuse and women's fear of childbirth and preference for cesarean section during second pregnancy were assessed using regression analyses, adjusting for confounding factors such as mode of delivery and birth experience of first pregnancy.
Of 4,876 women, 1,023 (21%) reported some form of childhood abuse. Compared to women without a history of childhood abuse, childhood-abused women more frequently reported fear of childbirth (23% vs. 15%, p
OBJECTIVES: To determine if a history of sexual abuse is associated with objective and subjective indicators of health and if certain abusive incidents had a stronger impact on health than others. DESIGN: A cross-sectional, multicentre study. SETTING: Five gynaecological departments in the five Nordic countries. SAMPLE: Three thousand five hundred and thirty-nine gynaecology patients. METHODS: The NorVold Abuse Questionnaire (NorAQ) on abuse history and current health was mailed to all patients who consented to participate. MAIN OUTCOME MEASURES: Reason for index visit at the gynaeocological clinic as well as several questions on health were recorded. General health status was measured as self-estimated health, psychosomatic symptoms (headache, abdominal pain, muscle, weakness, dizziness), number of health care visits and number of periods on sick leave. RESULT: A history of sexual abuse was reported by 20.7% of respondents. A history of sexual abuse was significantly associated with chronic pelvic pain as reason for index visit (P
Studies suggest that health complaints, distress and poor life satisfaction are associated with infertility experience. Research on health consequences of infertility experience in women has relied heavily on clinic-based samples. This population-based study investigates the association between infertility and health and life satisfaction.
Cross-sectional population-based health study, conducted between 2006 and 2008.
All women in a county in Norway were invited. The current material is restricted to women aged 20-49 years.
A total of 9200 women participated.
Health measures were compared between women with infertility experience (infertile women) and women without infertility experience (non-infertile women). Disparities in health and life satisfaction among the infertile women were assessed.
Self-reported health, functional impairment, depression, anxiety, and life satisfaction.
Some 15.4% of the women had experienced infertility. Infertile women reported poor self-reported health and functional impairment significantly more often than non-infertile women. Childless infertile women had significantly raised adjusted risks for health complaints and dissatisfaction with life compared with non-infertile women with a child, whereas infertile women with a child did not. Differences in health and life satisfaction emerged among the infertile women, but the differences were not significant. There were no significant differences in depression and anxiety between infertile and non-infertile women, or between the two groups of infertile women (with/without a child).
The study confirms the adverse effect of infertility on health and life-satisfaction. The childless infertile women stand out as being vulnerable to the detrimental consequences of infertility.
this study aimed to explore the association between lifetime sexual violence and expectations about childbirth.
Norwegian population-based cohort study.
women presenting for routine ultrasound examinations were recruited to the Norwegian Mother and Child Cohort Study between 1999 and 2008.
78,660 pregnant women.
sexual violence and expectations about childbirth were self-reported during pregnancy using postal questionnaires. Risk estimations were performed using multivariable logistic regression analysis and stratified by parity.
fear of childbirth, the thoughts about pain relief, worries about the infant's health and looking forward to the arrival of the infant.
of 78,660 women, 18.4% reported a history of sexual violence and 0.9% were exposed to sexual violence within the last 12 months, including during the current pregnancy. We found that nulliparous women who reported previous or recent sexual violence had a decrease in the odds of looking forward to the arrival of the infant with an AOR of 0.8 (95% CI 0.7-0.9) and 0.4 (95% CI 0.3-0.6), respectively, compared to non-abused women. The same pattern was observed among multiparous women and they were more likely to report worries about the infant's health. Severe sexual violence (rape) was associated with concerns about childbirth, especially for nulliparous women that were more likely to express fear of birth, a hope for a pain-free birth, a desire for caesarean section and worries about the infant's health than non-exposed women.
women with a lifetime exposure to sexual violence, both past experiences and within the last 12 months, were less likely to look forward to the arrival of the infant than non-exposed women, and they were more likely to worry about the infant's health. Women with experiences of severe sexual violence (rape) had more concerns about childbirth than women without this experience. This finding shows that exploring women's attitudes toward childbirth may work as an approach when examining exposure to violence.
To describe mental health status in native and non-native Swedish-speaking pregnant women and explore risk factors of depression and posttraumatic stress (PTS) symptoms.
A cross-sectional questionnaire study was conducted at midwife-based antenatal clinics in Southern Sweden.
A non-selected group of women in mid-pregnancy.
Participants completed a questionnaire covering background characteristics, social support, life events, mental health variables and the short Edinburgh Depression Scale.
Depressive symptoms during the past week and PTS symptoms during the past year.
Out of 1003 women, 21.4% reported another language than Swedish as their mother tongue and were defined as non-native. These women were more likely to be younger, have fewer years of education, potential financial problems, and lack of social support. More non-native speakers self-reported depressive, PTS, anxiety and, psychosomatic symptoms, and fewer had had consultations with a psychiatrist or psychologist. Of all women, 13.8% had depressive symptoms defined by Edinburgh Depression Scale 7 or above. Non-native status was associated with statistically increased risks of depressive symptoms and having =1 PTS symptom compared with native-speaking women. Multivariate modeling including all selected factors resulted in adjusted odds ratios for depressive symptoms of 1.75 (95% confidence interval: 1.11-2.76) and of 1.56 (95% confidence interval: 1.10-2.34) for PTS symptoms in non-native Swedish speakers.
Non-native Swedish-speaking women had a more unfavorable mental health status than native speakers. In spite of this, non-native speaking women had sought less mental health care.
The rate of cesarean section (CS) for non-medical reasons has risen and it is a concern for health care. Women's preferences may vary across countries for psychosocial or obstetric reasons.
A prospective cohort study of 6549 women in routine antenatal care giving birth in Belgium, Iceland, Denmark, Estonia, Norway or Sweden. Preference for mode of birth was self-reported in mid-pregnancy. Birth outcome data were collected from hospital records.
A CS was preferred by 3.5% of primiparous women and 8.7% of the multiparous women. Preference for CS was associated with severe fear of childbirth (FOC), with a negative birth experience in multiparous women and with depressive symptoms in the primiparous. Women were somewhat more prone to prefer a cesarean in Iceland, odd ratio (OR) 1.70 (1.02-2.83), adjusted for age, education, depression, FOC, history of abuse, previous cesarean and negative birth experience. Out of the 404 women who preferred CS during pregnancy, 286 (70.8%) delivered by CS, mostly for a medical indication. A total of 9% of the cesareans in the cohort had a non-medical indication only.
Women's preference for CS often seems to be due to health concerns. Both medical and psychological factors need to be addressed in antenatal counseling. Obstetricians need to convey accurately to women the risks and benefits of CS in her specific case. Maternity professionals should identify and explore psychosocial reasons for women's preferences.
The caesarean (CS) section rate varies among hospitals in Norway, and little is known about whether this is influenced by women's preferences. The aim of this study was to investigate the differences in women's preferred mode of delivery during pregnancy between five hospitals in Norway, and to relate this to the actual mode of delivery.
A prospective cohort study of 2,177 unselected pregnant women in five hospitals in Norway. Women were recruited at their standard ultrasound examinations, and data was collected through questionnaires and electronic patient charts. The exposure was a CS preference and the main outcome measure was the actual mode of delivery.
In total, 3.5% of the primiparous women and 9.6% of the multiparous women reported a preference for CS. This was associated with fear of childbirth and education between 10 and 13?years in both groups, symptoms of depression and an age over 35?years old among the primiparous women, and a previous CS and/or negative birth experience among the multiparous. The multiparous women in Drammen and Tromsø were less likely to prefer a CS, and none of the primiparous women in Tromsø preferred a CS. A total of 67.8% of those who preferred a CS gave birth with this mode of delivery.
There were significant differences between the hospitals according to the CS preference. This preference was associated with the previous obstetric history and psychological factors. Therefore, creating good birth experiences and offering women counselling may reduce the CS preference rate.